AB0467 COMPARISON OF 2002 AECG AND 2016 ACR/EULAR CLASSIFICATION CRITERIA AND ROLE OF SALIVARY GLAND ULTRASONOGRAPHY IN A SICCA COHORT
Authors: R. Solans-Laqué, A. Portella Alegre, M. Planes-Conangla, J. Mestre-Torres, X. Serres-Créixams, M. I. González-Nieto
Journal: Annals of the Rheumatic Diseases (2022)

Background For the last 20 years, different classification criteria have been used in clinical practice to improve the diagnosis of primary Sjögren’s syndrome (pSS) and for research purposes. Several recent studies have assessed major salivary gland ultrasonography (SGUS) as a tool for diagnosing pSS and its inclusion in the classification criteria sets. In addition, some research suggests that it may be important to distinguish between monospecific antibody assays to Ro60 or Ro52. Objectives To compare the new 2016 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) criteria to the revised 2002 American–European Consensus Group (AECG) criteria in a cohort of subjects with sicca symptoms and to assess the diagnostic accuracy of SGUS. We include monospecific antibody determination to Ro60 or Ro52. Methods Patients ≥ 18 years old with diagnosis of sicca syndrome without other associated collagen diseases were included. The initial cohort compromised 72 patients. We assessed features of salivary and lacrimal gland dysfunction and autoimmunity as defined by tests of both AECG and ACR/EULAR criteria. We included separate antiRo52 and antiRo60 antibodies determination, and considered only antiRo60 for the ACR/EULAR criteria as recommended [1]. All the patients underwent SGUS. Agreement between the criteria sets was assessed using Cohen’s κ coefficient, and categorical variables were compared using the Chi-square test. Results Application of the AECG criteria resulted in the classification of 50 (69%) subjects with pSS, among whom 48 (67%) subjects also met ACR/EULAR criteria. All these patients received a physician diagnosis of pSS. No patients met ACR/EULAR only, and 22 (31%) subjects met neither criteria set. The concordance between AECG and ACR/EULAR criteria was almost perfect (κ = 0.94). The concordance group presented 8% antiRo60+, 4% antiRo52+, and 75% antiRo60+/antiRo52+, among whom 56% had antiRo60+/antiRo52+/antiLa+. No patients presented antiLa in the absence of both antiRo60 and antiRo52 antibodies. SGUS was abnormal in 63% of these patients. The 2 patients fulfilling only AECG criteria had antiRo52+, and SGUS was abnormal in one of them. SGUS was abnormal in 27% of the 22 patients fulfilling no criteria sets. Thus, SGUS was abnormal in a significantly higher proportion of patients with pSS, in comparison to non-Sjögren’s sicca subjects (62% vs. 27%, p=0.007). Including SGUS among the ACR/EULAR criteria would increase the concordance from κ = 0.94 to κ = 0.97 between the criteria set. Conclusion The two sets of classification criteria yielded concordant results with an almost perfect agreement in our sicca cohort. The presence of both antiRo60 and antiRo52 antibodies was the most characteristic autoimmune pattern, with no detection of antiLa in the absence of them. SGUS was positive in a higher proportion of patients with pSS and may improve the classification criteria. References [1]Mariette X, Criswell LA. Primary Sjögren’s Syndrome. N Engl J Med. 2018;378(10):931-939. doi: 10.1056/NEJMcp1702514. Disclosure of Interests None declared